采用 STARmed 射频消融的牛肝消融面积的实验研究。
Experimental Study of the Ablation Area of Bovine Liver Using STARmed Radiofrequency Ablation.
机构信息
Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan;
Department of Clinical Engineering, Saiseikai Niigata Hospital, Niigata, Japan.
出版信息
In Vivo. 2023 May-Jun;37(3):1047-1051. doi: 10.21873/invivo.13179.
BACKGROUND/AIM: Ablating a spherical area during hepatocellular carcinoma ablation therapy is a very important issue. We aimed to determine the ablation area of bovine liver using various radiofrequency ablation (RFA) protocols.
MATERIALS AND METHODS
Bovine liver (1-2 kg) was placed in an aluminum tray, which was punctured with STARmed VIVA 2.0 17-gauge (G) and 15-G electrodes using a current-carrying tip. Under the step-up or linear method, with an ablation time up to one break and RFA output stop, the size of the color change area (representing the thermally coagulated area) of the bovine liver was measured along the vertical and horizontal axes, and the ablated volume and total heat generated were calculated.
RESULTS
5-W per minute increases protocol resulted in greater horizontal and vertical diameters of the ablated area than 10-W per minute increases protocol under the step-up method. For 5-W and 10-W per minute increases under the step-up method, the aspect ratio was 0.81 and 0.67 with a 17-G electrode, and 0.73 and 0.69 with a 15-G electrode, respectively. For 5-W and 10-W increases under the linear method, the aspect ratio was 0.89 and 0.82, respectively. Sufficient ablation was obtained, with vertical and horizontal diameters of 50 mm and 43.50 mm, respectively. Although the ablation time was long, the watt output value at the break and average watt value were low.
CONCLUSION
Gradual increase in output (5 W) using the step-up method yielded a more spherical ablation area, and longer ablation time in the linear method with a 15-G electrode could result in a more spherical ablation area in real clinical practice in humans. Future studies should examine concerns regarding long ablation times.
背景/目的：在肝细胞癌消融治疗中消融一个球形区域是一个非常重要的问题。我们旨在使用各种射频消融（RFA）方案确定牛肝的消融区域。
材料和方法
将牛肝（1-2 公斤）放置在铝托盘内，使用带电流传导尖端的 STARmed VIVA 2.0 17 号（G）和 15-G 电极进行穿刺。在逐步升压或线性方法下，直至消融时间达到一次中断且 RFA 输出停止，测量牛肝的颜色变化区域（代表热凝固区域）的垂直和水平轴的大小，并计算消融体积和总产热量。
结果
逐步升压法下，5-W 每分钟增加方案导致的消融区域的水平和垂直直径大于 10-W 每分钟增加方案。对于逐步升压法下的 5-W 和 10-W 每分钟增加方案，17-G 电极的纵横比分别为 0.81 和 0.67，15-G 电极的纵横比分别为 0.73 和 0.69。对于线性法下的 5-W 和 10-W 增加方案，纵横比分别为 0.89 和 0.82。获得了足够的消融，垂直和水平直径分别为 50 毫米和 43.50 毫米。虽然消融时间较长，但中断时的瓦输出值和平均瓦值较低。
结论
逐步升压法中逐渐增加输出（5 W）会产生更球形的消融区域，而在人类的实际临床实践中，使用 15-G 电极的线性方法中更长的消融时间可能会导致更球形的消融区域。未来的研究应关注长消融时间的问题。
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